HomeMy WebLinkAboutShoreline Pre-Inspection - PLN General - 5/18/2000 la_D4 FAX 36F)4277788 WON COUNTY 011) 3
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MASON COUNW
SHORELINE PRE-INSPECTION APPLICATION
470.00 Fee
�i7 ►� ��,�CZ..� G C ��la!Applicant-_ _ ---
1- ApplicantAddress.
Sit* Address: /, S/ G WG city"
Owner Ad
City; TT�r� St � lp¢- y3 Phone: _I i
2. Por"l No. 3' 7 - U c>
d don:
Legal Dew p
�'-
c. 7 C
4. Use of Building: ._
S. Is there any type or water ort or adjacent ro firoperty7: saltwater lake
aUter
wetland
river pond - ---- —
sbrearn► seen:�onal ctenk^_._. --- V) 61
77 4,
Virectiann 1n Site: $
If the inforrrxition is Incomplete, ttten Mason County must dlsrmmainIaim n valid only until
ng from
deficiencies In the original appltG$tinn. pre-Insch aI n reports In tlils ins ecdun_
vi irli wh
"ch af1'e�t the tat evaluated
develo rn�rlt than � oct�ur in the t� _
Date: `3
Applicant Si nature: C
netvrri nl;c-gtjon txy: oepartme.nt of Cornmuruty Develr,p11ient.planning Division
P-0, Box 5W3
Shelturt, WA 9858"1
(360) 427-9670
pir-ose include a 070-00 cirnck or money order pnyable to masur+ county Tinamr-rer
Fort OfrICL Date:
USE ONLY: AC pt by.